The"like with like"and the"flap thinning"are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand.These principles are underpinned ...The"like with like"and the"flap thinning"are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand.These principles are underpinned by a thorough knowledge of anatomy and functional hand units,with a wide range of reconstructive procedures that must be finalized to the necessity of the impaired structures."Like with like"means that a lost tissue must be replaced with another one that can be compared in appearance and function.In addition,good cosmetic is often associated with good function because the complex attempt to get a proper aesthetic always traduces itself into a better functional reconstruction."Flap thinning"is essential because soft tissue injuries of the hand represent a more difficult reconstructive challenge than similar injuries elsewhere,and the need for thin tissue to wrap the superficial noble structures of the hand is constant.However,the procedure of thinning a flap can be dangerous and must adhere to the vascular architecture of the flap.This paper aims to review and briefly summarize the current literature in this field.展开更多
With advances in anatomical knowledge and technology,increased interest has been directed towards reconstruction with enhanced aesthetic and functional outcomes.A myriad of thinned perforator flap harvest approaches h...With advances in anatomical knowledge and technology,increased interest has been directed towards reconstruction with enhanced aesthetic and functional outcomes.A myriad of thinned perforator flap harvest approaches have been developed for this purpose;however,concerns about jeopardizing their vascularity remain.To ensure optimum reconstructive outcome without hampering the flap’s microcirculation,it is important to make good use of the existing advanced imaging modalities that can provide clear visualization of perforator branches,particularly in the adipose layer,and an accurate assessment of flap perfusion.Therefore,this review will highlight the imaging modalities that have been utilized for harvesting a thinned perforator flap from these two perspectives,along with future insights into creating both functionally and aesthetically satisfying,yet simultaneously safe,thinned perforator flaps for the best reconstructive outcomes for patients.展开更多
文摘The"like with like"and the"flap thinning"are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand.These principles are underpinned by a thorough knowledge of anatomy and functional hand units,with a wide range of reconstructive procedures that must be finalized to the necessity of the impaired structures."Like with like"means that a lost tissue must be replaced with another one that can be compared in appearance and function.In addition,good cosmetic is often associated with good function because the complex attempt to get a proper aesthetic always traduces itself into a better functional reconstruction."Flap thinning"is essential because soft tissue injuries of the hand represent a more difficult reconstructive challenge than similar injuries elsewhere,and the need for thin tissue to wrap the superficial noble structures of the hand is constant.However,the procedure of thinning a flap can be dangerous and must adhere to the vascular architecture of the flap.This paper aims to review and briefly summarize the current literature in this field.
基金supported by grants from National Natural Science Foundation of China(81772086,82072177),‘Two Hundred Talent’program,‘Outstanding Youth Medical Talents’Shanghai‘Rising Stars of Medical Talent’Youth Development Program and Shanghai Jiao Tong University‘Chenxing’Youth Development Program(Associate Profes-sor Type A).
文摘With advances in anatomical knowledge and technology,increased interest has been directed towards reconstruction with enhanced aesthetic and functional outcomes.A myriad of thinned perforator flap harvest approaches have been developed for this purpose;however,concerns about jeopardizing their vascularity remain.To ensure optimum reconstructive outcome without hampering the flap’s microcirculation,it is important to make good use of the existing advanced imaging modalities that can provide clear visualization of perforator branches,particularly in the adipose layer,and an accurate assessment of flap perfusion.Therefore,this review will highlight the imaging modalities that have been utilized for harvesting a thinned perforator flap from these two perspectives,along with future insights into creating both functionally and aesthetically satisfying,yet simultaneously safe,thinned perforator flaps for the best reconstructive outcomes for patients.
